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Updated: Jun 21, 2025

Engineered Vascularized Muscle Flap

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Published on: January 11, 2016

[Fillet flap transfer as alternative to conventional lower limb amputation].

L Harnoncourt¹, C Gstoettner^1,2, L Pflaum¹

¹Klinisches Labor für Bionische Extremitätenrekonstruktion, Universitätsklinik für Plastische, Ästhetische und Rekonstruktive Chirurgie, Medizinische Universität Wien, Wien, Österreich.

Unfallchirurgie (Heidelberg, Germany)

|July 10, 2024

Summary

Spare part surgery using fillet flaps offers a novel solution for lower limb amputation challenges. This technique optimizes the residual limb stump for prosthesis fitting, improving patient outcomes and reducing discomfort.

Keywords:

Amputation stumps Body image Lower limb Neuralgia Sensation

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Area of Science:

Orthopedic Surgery
Reconstructive Surgery
Prosthetics

Background:

Lower limb amputation presents significant challenges in prosthesis fitting.
Current methods like skeletal stump-prosthesis interfaces and nerve transfers have limitations and introduce new impairments.
Innovative surgical approaches are necessary to address these issues.

Purpose of the Study:

To review prosthesis-associated discomforts and current treatment strategies.
To present alternative surgical concepts, focusing on fillet flap techniques.
To evaluate the advantages and disadvantages of various surgical options.

Main Methods:

A selective literature search was conducted.
Authors' experiences and perspectives on surgical treatment options were considered.
A clinical case study is presented to illustrate the technique.

Main Results:

Transferring the sole of the foot as a fillet flap creates a fully weight-bearing stump.
This method prevents neuralgia, preserves sensation, and maintains body image.
The technique is applicable to below and above-knee amputations, provided the calcaneal region is intact.

Conclusions:

Fillet flap transfer optimizes the residual limb for prosthesis fitting.
Individual patient evaluation is crucial for determining bone inclusion in the flap.
This approach enhances the potential for successful prosthesis use and patient satisfaction.